Emerging Infections & Biothreats

Public health emergencies caused by infectious threats have the potential to kill thousands or millions of people. These threats can emerge naturally as outbreaks or pandemics, such as influenza (pandemic and seasonal), severe acute respiratory syndrome (SARS), extremely-drug resistant (XDR) tuberculosis, New Delhi metallo-b-lactamase 1 (NDM1), antibiotic-resistant bacterial infections, and HIV/AIDS. Or, they can emerge deliberately through bioterrorism, such as the 2001 anthrax attacks or potential threats posed by smallpox, tularemia, and plague. Infectious threats can undermine not only patient care and public health, but also national security. Influenza pandemics, for example, have a long history of devastation in terms of lives lost, hospitalizations, and destabilizing national economies.

Each day, infectious diseases physicians and scientists serve on the front lines in protecting us from such threats. IDSA advances U.S. preparedness and response initiatives by promoting appropriate action by health care providers, strengthened public health and research efforts, development of life-saving countermeasures (vaccines, drugs and diagnostics), and implementation of appropriate non-therapeutic control measures.

IDSA’s Efforts on Public Health Emergencies and Biothreats

The Infectious Diseases Society of America (IDSA) welcomes the action taken by Congress to prevent a government shutdown and provide $1.1 billion for responses to the continuing spread of the Zika virus.

IDSA joined Trust for America's Health (TFAH) and the UPMC Center for Health Security calling for the United States to take additional steps to prepare for MERS-CoV and other emerging infections. The brief argues that public health and healthcare systems cannot afford to become complacent in preparing for infectious disease threats and that system-wide preparedness is needed for potential outbreaks.

In connection with a February 2015 Congressional hearing, "Examining the US Public Health Response to Seasonal Influenza," IDSA submitted written testimony highlighting the importance of building a strong public health infrastructure to protect the public from severe illness and death caused by seasonal influenza. The letter urges a greater investment in public health preparedness as well as research and development programs for influenza vaccines and antivirals.

In a letter to newly-appointed U.S. Ebola Response Coordinator Ron Klain, IDSA President Dr. Stephen Calderwood outlined the Society's Ebola response efforts to date and volunteered IDSA's expertise and resources to help the federal government coordinate the U.S. and global response.

IDSA responded to an FDA and NIAID request for public comments on how to improve clinical trial designs under the unique conditions in emerging infectious diseases. IDSA provided recommendations on addressing informed consent, striving for standard of care, and the importance of tailoring a clinical trial based on the specific circumstances of each outbreak as well as the intervention being studied.

IDSA responded to an HHS Notice of Proposed Rule Making to add influenza viruses that contain A/Gs/Gd/1/96 Hemagglutinin (HA), including wild-type viruses, as non-Tier 1 select agents and viruses that have additionally made transmissible among mammals by respiratory droplets in a laboratory as Tier 1 select agents. IDSA supported this proposal, and reaffirmed the importance of maintaining a balance between the public health risk of impeding research with these viruses against the public health risk of an accidental laboratory risk or act of bioterrorism.

IDSA submitted comments to the Assistant Secretary for Preparedness and Response (ASPR) on the agency's 2015-2018 draft National Health Security Strategy (NHSS). IDSA applauds the agency's comprehensive approach to national security and the inclusion of "One Health" principles in the strategy, while offering substantive comments on various components of the NHSS most relevant to ID physicians and their patients.

IDSA advocates balancing the public health risk of impeding the conduct of H5N1 research against the public health risk of an accidental laboratory release or act of bioterrorism. IDSA recommends that naturally occurring H5N1 viruses and vaccine strains be regulated as HHS select agents with current biosafety and biosecurity regulations, while H5N1 viruses that have been engineered for greater transmissibility or pathogenicity be regulated as Tier 1 select agents, and with increased biosafety and biosecurity restrictions.

IDSA and HIVMA wrote to members of the House Energy and Commerce Committe's Subcommittee on Oversight and Investigations thanking them for scheduling the hearing “Examining HHS’s Public Health Preparedness for and Response to the 2017 Hurricane Season.” IDSA and HIVMA are concerned about the potential infectious diseases risks posed by hurricanes.

Senators Angus King (I-ME), Bill Nelson (D-FL), and Richard Burr (R-NC) introduced the Strengthening Mosquito Abatement for Safety and Health (SMASH) Act. The bill renews approval for existing programs that assist state and local public health departments in preventing mosquito-borne illnesses such as Zika. IDSA provided a letter supporting the legislation.

In response to the current Zika virus outbreak in the Americas, IDSA developed policy recommendations on how best to address Zika virus both within the US and globally. These recommendations aim to ensure adequate federal support to strengthen our public health prevention and control, diagnostic development, medical countermeasures research and development, and global health activities. IDSA relayed these recommendations in a letter to the Senate Health, Education, Labor, and Pensions (HELP) Committee, which held a hearing on the Zika virus outbreak on February 24.

In connection with a February 2015 Congressional hearing, "Examining the US Public Health Response to Seasonal Influenza," IDSA submitted written testimony highlighting the importance of building a strong public health infrastructure to protect the public from severe illness and death caused by seasonal influenza. The letter urges a greater investment in public health preparedness as well as research and development programs for influenza vaccines and antivirals.

A report on the Project Bioshield Act that gives the federal government new authorities over the development, procurement, and use of medical countermeasures against chemical, biological, radiological, and nuclear (CBRN) terrorism agents. Congress is currently considering whether these authorities have sufficiently contributed to national preparedness to merit extension.

The BARDA Strategic Plan defines a set of core principles that will improve BARDA's ability to manage resources efficiently, strengthen public-private partnerships, and promote the broad categories of countermeasures that BARDA is most interested in pursuing to protect health and save lives in a public health emergency.